Shearer A, Bagust A, Sanderson D, Heller S, Roberts S
York Health Economics Consortium, University of York, Vanbrugh Way, Heslington, York, YO10 4NH , UK.
Diabet Med. 2004 May;21(5):460-7. doi: 10.1111/j.1464-5491.2004.01183.x.
To determine the cost-effectiveness of a structured treatment and teaching programme (STTP) combining dietary freedom with insulin adjustment for Type 1 diabetes.
Incremental cost-effectiveness analysis based on effectiveness data from three RCTs in Germany, Austria, and Dose Adjustment for Normal Eating (DAFNE) in the UK, to model the long-term microvascular complications of Type 1 diabetes.
The STTP approach yields effectiveness gains at a lower cost compared with current standard practice for treatment of Type 1 diabetes. STTPs are likely to save 0.05 life years, yield 0.12 EuroQol 5 dimensions (EQ-5D) and 0.09 visual analogue scale (VAS) incremental quality-adjusted life years, and save approximately pound 2200 per patient treated discounted over 10 years.
Introducing STTPs as standard treatment for people with Type 1 diabetes in the UK may help to achieve the primary goal of the National Service Framework (NSF) for Diabetes by enabling individuals to manage their own lifestyle and condition. In doing so it could save valuable resources for the NHS and yield important morbidity and mortality gains.
确定一项结构化治疗与教学计划（STTP）的成本效益，该计划将饮食自由与1型糖尿病患者的胰岛素调整相结合。
基于德国、奥地利的三项随机对照试验（RCT）以及英国的正常饮食剂量调整（DAFNE）的有效性数据进行增量成本效益分析，以模拟1型糖尿病的长期微血管并发症。
与目前1型糖尿病的标准治疗方法相比，STTP方法以更低的成本产生了有效性提升。STTP可能节省0.05个生命年，产生0.12个欧洲五维度健康量表（EQ-5D）和0.09个视觉模拟量表（VAS）增量质量调整生命年，并且在10年的贴现期内，每位接受治疗的患者可节省约2200英镑。
在英国将STTP作为1型糖尿病患者的标准治疗方法引入，可能有助于实现糖尿病国家服务框架（NSF）的主要目标，即让患者能够管理自己的生活方式和病情。这样做可以为英国国民健康服务体系（NHS）节省宝贵的资源，并在发病率和死亡率方面取得重要成果。
